Worcester vet's care questioned

Tuesday

Jun 25, 2013 at 6:00 AM

Leonard Giguere of Worcester earned a Purple Heart for his actions in Vietnam, but his real one wasn't strong enough for the poor treatment he received at the Veterans Administration hospital in West Roxbury, according to a lawyer for his family.

Mr. Giguere was 58 when he died in 2005, four days after undergoing coronary artery bypass graft surgery. And while a federal judge determined that the hospital was not to blame, he also made a rather troubling finding. Mr. Giguere received "less than perfect care" at the VA hospital, and a different course of treatment might have saved him.

The family's lawyer, Brian Burke, plans to petition the U.S. Supreme Court to review the decision of U.S. District Judge Dennis Saylor, who found in favor of the United States in 2011 after a five-day bench trial.

"In effect, the District Court said that if this veteran had undergone his surgery at the Lahey Clinic, a private hospital, Leonard Giguere would have lived, but since he went to a VA hospital run by the federal government, he died and no one there is to blame," Burke said.

Forty years before he died, Mr. Giguere was injured while serving as an army combat tracker in Vietnam, when a land mine exploded and pushed a portion of his stomach and intestines into his chest. He recovered and was healthy late into his 50s.

On May 4, 2005, he suffered chest pains and was admitted to the VA hospital. Two days later he underwent surgery, and four days after that he died of a heart attack. The widower and grandfather was self-employed and had no health insurance.

According to trial records, post-op patients often develop an ileus, which is the cessation of digestive function. In Mr. Giguere's case, his stomach was plastered up against his lungs and began to expand, distressing his already compromised cardiopulmonary system. The additional stress from the ileus led to his heart attack while doctors were inserting a naso gastro tube, Burke said.

The family filed a medical malpractice case, faulting the surgical team for failing to be alert to the greater dangers an ileus presented to Mr. Giguere, and for failing to insert the NG tube earlier.

The case was heard by Judge Saylor, who did not issue written findings for almost a year. He agreed with the family's medical expert witness, Dr. Andrew Warner of the Lahey Clinic, that the death was preventable. Still, he found no liability on the part of the VA hospital and said its approach did not deviate from standard medical practice.

Instead, he wrote that "in hindsight, it seems likely that a different course of treatment might have led to a different outcome" and that "Dr. Warner's viewpoint ... represents how a physician with a relatively high degree of skill and foresight would have approached the issue. In the ultimate analysis, Dr. Warner's approach was likely 'right,' in the sense that it was more likely that the patient would have survived had his suggested course of conduct been followed."

Yesterday, Burke called the decision "extremely troubling" and said families should be aware that the government does not hold VA hospitals to the same standard as private hospitals. Shortly before taking the Giguere case, he filed a suit involving another veteran who died under similar circumstances.

"Excusing ... the VA hospital for failing to prevent this patient's clearly preventable death has grave implications for veterans' health care in this country," Burke said.

Mr. Giguere's daughter, Cindy Jackson, put it another way.

"My father was there for his country," she said. "But his country wasn't there for him when he needed it."